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Getting the latest healthcare news for you
A new scoring tool combining orbital ultrasound and visual function tests can predict which Graves disease patients are most likely to develop orbitopathy — the eye-bulging, vision-disrupting complication — before symptoms appear. The FUMO score showed a strong positive predictive value of 0.96, making it especially useful for identifying high-risk patients. Experts say the approach is promising but may face real-world adoption challenges.
Researchers at the University of Cagliari have developed a new risk scoring tool — called the FUMO (Functional and Morphological) score — that uses orbital ultrasound and visual function tests to predict which Graves disease patients are likely to develop orbitopathy. The condition, which causes eye swelling, bulging, light sensitivity, and double vision, affects an estimated 25%–40% of people with Graves disease. The FUMO score detects subtle muscle thickening and tissue changes in the orbit before clinical signs like proptosis or restricted eye movement appear — sometimes months in advance.
In a study of 156 patients followed from 2018 to 2024, the tool performed well at identifying high-risk individuals but was less reliable at ruling out risk in low-scoring patients. Researchers suggest that patients with medium-to-high FUMO scores should receive closer ocular monitoring and may benefit from antithyroid drugs or thyroidectomy over radioactive iodine therapy.
By the Numbers:
Why it matters: Early identification of high-risk Graves orbitopathy patients could meaningfully change treatment decisions and monitoring strategies — but experts caution the tool needs multicenter validation and may be difficult to scale beyond specialized academic centers.
